The Brief

For customers using a telehealth website to get cheaper versions of popular obesity drugs, the low prices turned out to be too good to be true.

Customers of Zappy Health tell NPR they were drawn to the online provider by its low prices, its lack of subscription fees and its handy smartphone app with a chat feature for patients to talk to one another during their weight-loss journeys.

The Zappy chat was ultimately how many customers first learned that Ousia Pharmacy — one of several pharmacies that supplied Zappy with compounded obesity drugs — didn't have a required license, one that ensured the drugs were produced in accordance with safety and potency standards.

Compounded drugs that Zappy and other telehealth sites sell aren't generics. Instead, they're essentially copies of the name-brand drugs, made by specialized pharmacies. The Food and Drug Administration allows this kind of compounding during drug shortages.

Compounding pharmacies are regulated at the state level. Ousia, in Spring Hill, Fla., didn't have what's called a sterile compounding license. The obesity drugs made by compounding pharmacies are given by injection, so attention to sterile production is critical to avoid contamination that could cause infections.

Zappy didn't find out about Ousia's licensing problem until December and it ceased its roughly three-month relationship with the pharmacy on Dec. 13, Zappy's founder, Dr. Michel Choueiri, told NPR in an email after a broadcast version of this story aired. He called Zappy "the biggest victims of this situation" and said that it has left the company in "severe financial and reputational ruin."

Some Zappy customers NPR spoke with found out about the problem on Reddit.

Laura Franzese, in Portland, Ore., learned about the licensing problem after spending $1,000 on a bulk order of tirzepatide from Zappy that arrived with Ousia labels. (Tirzepatide is the active ingredient in Eli Lilly's obesity drug Zepbound.) She'd been taking the drugs already, from a local provider, and called them "life-changing," but made the switch to Zappy hoping to save money.

"I bought three months' worth of medicine from this company," she says. Now she's afraid to use the drugs. "It was a big investment."

People active on Reddit told NPR that Zappy deleted the original user post in its app chat forum about Ousia's lack of the proper license. Choueiri says Zappy publicly apologized in the same forum and removed the post only while it was verifying the claim.

Ousia couldn't be reached for comment.

When Laura Franzese started with compounded tirzepatide at a local medical spa, she lost 20 pounds in 16 weeks. "It's giving me something that my body clearly needed," she says. But it was expensive. She discovered she could get a lower price from Zappy Health.

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Laura Franzese

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For many people who've turned to online telehealth companies to find compounded obesity drugs, they say they would prefer to take the brand-name drugs, but it isn't an option for them. They say Novo Nordisk's Wegovy and Eli Lilly's Zepbound aren't covered by their insurance. And paying the full sticker price — more than $1,000 a month — is too expensive.

Compounding pharmacies fill a gap for patients like this. They've been a part of the health care landscape for decades, preparing custom medicines for people who need them, but booming demand for weight-loss drugs — as well as resulting brand-name shortages — has brought them into new prominence.

Even some people who have health insurance coverage for obesity drugs say they turn to telehealth and compounding because they couldn't reliably find the brand-name drugs in local pharmacies.

But the situation with Ousia shows the pitfalls of navigating the world of online compounded obesity drugs, which includes legitimate businesses as well as some unlicensed or unregistered ones. It can be difficult for consumers to tell the difference or trust the quality of the obesity drugs they're buying.

Looking for a deal, finding confusion

For Zappy customers, the problems came as a surprise.

Eric Bishop, an IT professional in Salt Lake City, was looking for a way to buy more tirzepatide at once, fearing that the official end to the Zepbound shortage would mean the end of the compounded version. He had been filling his prescription at a local brick-and-mortar compounding pharmacy but turned to Zappy to buy a stockpile.

He didn't know which pharmacy would be fulfilling the order through Zappy until after he paid. "They didn't give me a choice," he says.

Bishop had just gotten his nine-month supply of tirzepatide, worth $2,700, from Zappy when users on the Zappy app blew the whistle on Ousia.

"That's when I started seeing things in the chat," he says of the app's patient forum feature. "So I bounced over to Reddit."

According to a complaint filed by the Florida Department of Health on Dec. 5, Ousia applied for a sterile compounding license in March 2024, but it was never granted. When state regulators inspected the facility later that year in August, they discovered that it was compounding medicines anyway. In addition, inspectors noted that Ousia was improperly storing drugs that needed to be refrigerated and not keeping proper records for drugs it dispensed.

The Florida Department of Health did not respond to requests for comment on this story. In an email to NPR, Zappy's founder, Choueiri, said the department failed to disclose Ousia's problem "in a timely manner."

Bishop couldn't believe what he was reading.

"I'm all of a sudden, you know, about ready to start taking my medication and I'm like, I now no longer have any confidence in what I have," Bishop says. "And I might either want my money back or I want a replacement for what I have."

Eric Bishop helps run a Facebook group for people who got Ousia vials from Zappy Health and are trying to get their money back. Since Ousia gave up its regular pharmacy license on Jan. 31, he says, some people have been more successful.

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Courtesy Eric Bishop

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Another Zappy patient, Nicole Drong, in Minneapolis, says she was surprised when vials marked "Ousia" arrived at her home. "I did not know the name of the pharmacy until I got a package. And I was like, 'Well, that's weird. I thought it was going to say 'Zappy' on it.'"

Then in December, she noticed the Zappy app was sending her a lot more notifications than usual from the patient forum. Word was out that Ousia didn't have a sterile compounding license.

"I kind of feel stupid, I guess," Drong says. She says she was " just blindly putting trust in this pharmacy. … How often do you ever have to double-check your medication? Like, if I go get my antidepressants from Walgreens, do I have to double-check to make sure there's not anything extra in my bottle of pills?"

Choueiri, Zappy's founder, says patients have the opportunity to cancel once they learn which pharmacy is fulfilling their order, and it has responded to patient feedback to be more transparent with customers up front.

Confusion and no refunds

The bureaucratic details of licensing can be opaque to consumers. But these licenses matter, says Scott Brunner, who leads the trade group of compounding pharmacists, the Alliance for Pharmacy Compounding. Ousia pharmacy wasn't a member, he says.

He called not having a sterile compounding license where one is required "egregious."

"I would not take a drug that has been dispensed to that patient from a pharmacy that has been found to be in violation of its state license law," he says.

Choueiri did a TikTok live on Jan. 15, where he said Zappy was "made aware of the complaint" and wanted to let the process play out. He added that his family members were taking the Ousia medications too and that he was also fielding questions from them.

"It's not counterfeit?" he said, reading questions as they came in. "Yeah, no. No, it's not counterfeit. Um no, no. The short answer is no, but I'm not going to go down the legal litigation here."

At first, Zappy told people they could fill out a Google form to get a refund or replacement vials, but customers tell NPR that nothing has come of it yet. For a time, Zappy also told customers to ask Ousia for a refund instead.

On Jan. 31, 2025, Ousia voluntarily relinquished its regular pharmacy license, Florida records show. Now, the pharmacy's phone number goes to voicemail and its website is down.

Asked what Zappy is now advising its patients to do with their Ousia vials, Choueiri wrote to NPR: "As always, Zappy is a platform that connects patients to affordable care but does not replace the role of medical providers or pharmacists. Decisions about medication use should always be made in consultation with a licensed healthcare professional, and defer these conversations to the providers of care."

Zappy Health ads on Facebook and Instagram promote its weight-loss program, which involves connecting patients to online providers and sending them low-cost obesity drugs made by compounding pharmacies.

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Zappy/Images screenshot and compiled by NPR

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Choueiri is a medical doctor. On its website, Zappy touts that its weight-loss plans "are personalized by doctors."

According to Zappy's terms of service, the doctor-patient relationship isn't between Zappy and its users. It's between the providers who do virtual appointments and prescribing on Zappy and the Zappy customers. And the company "disclaims any liability for the medical or pharmaceutical services provided through its platform."

Spotting red flags

While the Ousia situation is unfortunate for the patients involved, it's an example of the regulatory system working the way it's supposed to, says Brunner.

The National Association of Boards of Pharmacy says it's hard to know how many online retailers are offering compounded obesity drugs that are made without the proper license or registration. State pharmacy boards oversee most compounding pharmacies around the U.S., but if a pharmacy isn't registered or licensed in a state where it's shipping products, it can be hard to track.

Betty Jones, compliance senior manager of the accreditation and inspection programs at NABP, says consumers can protect themselves by looking out for red flags. For instance, you should always know which pharmacy is filling your prescription, and they're required to provide counseling.

"If they're not providing you that offer of patient counseling or you're calling into that pharmacy and they don't allow you to, you know, be progressed to a pharmacist where you can ask questions, that would be something that I would call a red flag."

She says prices that are too low and pharmacies that don't ask for a prescription should also trigger alarm bells.

Potential customers should also be able to verify that a pharmacy is licensed, since these are public records available online in most states. And to dispense to you, that means the pharmacy needs to be licensed in your state, too — not just the one where it's located.

Bishop, the Zappy customer in Salt Lake City, says he helped organize a Facebook group for people to help them figure out how to get their money back. Customers say they haven't been able to get refunds.

Choueiri says Zappy's low prices mean it doesn't have much money left over after paying pharmacies and providers, and "Zappy does not control the funds necessary to issue refunds."

The Facebook group has grown to more than 600 people. Its members have even helped report new information to the Florida Department of Health, Bishop says. "We're just a community just kind of helping each other out."

Many of the group members' banks initially declined to reverse their credit card transactions with Zappy. That has started to change since Ousia relinquished its license, Bishop says. "Actually, some banks are even opening disputes that they closed previously."

Zappy is still advertising to customers, but Bishop says he isn't buying from the company again. He's back on compounded tirzepatide from his local pharmacy.
Copyright 2025 NPR

According to the Recording Academy itself, the Grammy for best new artist is for musicians who are having "a breakthrough into the public consciousness."

What did it look like to have a breakthrough moment in 2025? More often than not, it meant having a hit song on TikTok. At this weekend's Grammys, all eight best new artist nominees are musicians whose popularity skyrocketed thanks to the app.

"If there's anything that speaks to TikTok's power right now, I think it's this category in particular," says Robert Steiner, a media analyst at the music and entertainment insights company Luminate.

Last year, Luminate partnered with TikTok on a Music Impact report. It found what many powerbrokers in the music industry have known for awhile: The app is not only a large source of music discovery, but also a leading driver of chart success. According to the report, 84% of songs that entered Billboard's Global 200 chart went viral on TikTok first.

And music, in turn, is essential to the app as well. Steiner says going all the way back to its roots in Musically — a platform for lip-syncing videos — songs have been the currency for TikTok's biggest memes and dances.

"A lot of the trends that we see on TikTok are audio-based. Obviously video is part of it, but the sound is a huge aspect of it as well," Steiner says. "It was set up to really capitalize on audio becoming a key driver to the app, and I think as a result, it does seem like they created at least a segment of their user base that is very musically inclined."

Looking at this year's Grammy nominations, the best new artist contenders run the gamut from indie darlings who started making music a decade ago to former Hype House TikTok creators who launched recording careers in 2025. All eight nominees used the app in their ascent to pop stardom — but did they rise through the music industry into TikTok virality? Or the other way around?

Olivia Dean

The English singer is not a newcomer; as she told NPR's Morning Edition in September, she's been recording and releasing music for nearly a decade. In 2023, her album Messy was shortlisted for the U.K.'s Mercury Prize. But in 2025, the warm soul-pop melodies of her album The Art of Loving put her on the map in a major way. The single "Man I Need" became a hit on TikTok — it's been used in 1.7 million videos so far, according to the app — and quickly climbed the charts.

Did Olivia Dean come from TikTok or the music industry: The music industry. 

KATSEYE

Born out of a reality television competition show in 2023, KATSEYE is a global girl group seemingly created for TikTok virality — and so far, the sextet has delivered. In 2025, singles like "Gnarly" and "Gabriela" steadily climbed the charts; but perhaps more importantly, they soundtracked millions of videos on TikTok. Choreography from KATSEYE's Gap commercial (set to "Milkshake" by Kelis, not their own song) became a dance trend too, heralded as a clap back to Sydney Sweeney's controversial American Eagle jeans ad. In December, TikTok officially crowned KATSEYE its Global Artist of 2025.

Did KATSEYE come from TikTok or the music industry? Both.

The Marías

The indie pop band started releasing synth-driven, bilingual songs nearly a decade ago and collaborated with Bad Bunny on his 2022 album Un Verano Sin Ti. But it was a demo of their song "No One Noticed," which lead singer María Zardoya released unofficially on her TikTok account, that would become the band's biggest song to date, and was later officially released on their 2024 album Submarine. Zardoya told podcast host Zach Sang that despite being a slower, introspective song — the opposite of what the band's label wanted at the time — fans gravitated towards it on social media.

Did The Marías come from TikTok or the music industry? The industry via the independent route — they built a fanbase and eventually landed a record deal with Atlantic, then hit big on the app. 

Addison Rae

Originally from Lafayette, La. — cue the Britney Spears comparisons — Addison Rae became a TikTok sensation in 2019 by posting videos of herself dancing to viral songs. She moved to Los Angeles, joined the Hype House and amassed millions of followers, all of which then helped build momentum for a music career. After a co-sign from Charli XCX on the "Von Dutch" remix, she released her effervescent debut album Addison in June.

Did Addison Rae come from TikTok or the music industry? TikTok. 

sombr

Hailing from New York City's Lower East Side, the Gen Z rocker sombr has had his share of viral TikTok songs. His 2022 single "Caroline" was the first, helping him get signed to Warner Records when he was still 17 years old. Two more followed in 2025; his singles "Back to Friends" and "Undressed" were used on hundreds of thousands of TikTok videos and both steadily climbed Billboard's Hot 100 chart, months before sombr released his debut album I Barely Know Her.

Did sombr come from TikTok or the music industry? Both. 

Leon Thomas

A child Broadway star and former Nickelodeon actor, it's safe to say Leon Thomas has been grinding for decades. After being mentored by Babyface for years, the 32-year-old has produced for artists ranging from his Victorious co-star Ariana Grande to Rick Ross. In 2024, he won a Grammy for best R&B song for his contributions to SZA's "Snooze." But Thomas' sophomore album, MUTT, landed him directly in the spotlight — its lead single took off on TikTok and climbed Billboard's Hot 100 chart. Of this year's best new artist contenders, Thomas is the most widely recognized by the Recording Academy; he landed five additional nominations, including for album of the year.

Did Leon Thomas come from TikTok or the music industry? The music industry. 

Alex Warren

Another member of the Hype House collective, Alex Warren went from posting massively popular pranking videos online to releasing a romantic ballad — and instant wedding playlist staple — that spent months climbing Billboard's Hot 100 chart. "Ordinary" became one of the biggest hits of the summer, and earned Warren an invitation to perform with country superstar Luke Combs at Lollapalooza.

Did Alex Warren come from TikTok or the music industry? TikTok.

Lola Young 

Often drawing comparisons to previous best new artist winner Amy Winehouse, the 25-year-old had already released several albums before her 2024 single "Messy" went viral on TikTok. Young's songs had already been gaining traction on the app for a while — videos of her performing "Don't Hate Me" on a playground in 2023 racked up millions of views — but "Messy" became a different kind of phenomenon. Before performing at Coachella last spring, Young told NPR's Morning Edition that she does not identify as a TikToker, but recognized the massive impact the app has had on her career.

Did Lola Young come from TikTok or the music industry? The music industry.

More than a century after it first opened its doors, the Vermont Square Branch of the Los Angeles Public Library still is operating out of its original building, nestled among the homes on West 48th Street.

It’s not just a library. For generations, it’s been considered a safe place and gathering spot for people who otherwise may have no place to go. Today, the neighborhood council uses the room in the library’s basement for meetings, the grassy area out back is a place to relax, and for some, the building is a refuge from hot- and cold-weather days.

Of course, people also go there to read books, for free access to the internet and for children’s programming. But they also go there to find peace and quiet amid the hustle and bustle of inner-city Los Angeles.

“It feels safe. It’s pretty big. It’s nice inside and comfortable. There are people to talk to, and I can meet friends,” resident Moses Rogers told The LA Local.

The Vermont Square Branch was built in 1913 on what had been park land donated by the city of Los Angeles. It was funded with a Carnegie Foundation grant, the philanthropy of industrialist Andrew Carnegie, who funded the arts, higher education and public libraries after making his fortune in steel in the late 19th century.

The library is not the oldest branch in the city system, but it’s the first library building owned by the city. All other city libraries and facilities were housed in rented spaces.

It was designed in the architectural style of the Italian Renaissance, and you still can find the original circulation desk, windows that allow in natural light, old furniture and marble fixtures inside the library.

Branch manager Martha Sherod has worked at the library for 13 ½ years and calls the Vermont Square Branch a hidden treasure that some in the neighborhood can overlook. She said some people think it’s a government building, but for the people who grew up using the library, it symbolizes being home.

“People come here for a purpose, they want to be here. We really like serving them,” Sherod told The LA Local. “Now that I’ve been here so long, I’ve seen kids grow up from being little kids to college students. So, it’s really been a joy for me.”

Sherod said the branch holds about 24,000 items and has 4,500 visitors a month on average. The library also offers adult and teen programming, including free legal advice, health screenings, arts and crafts and book club activities.

“The library isn’t just for quietly sitting and reading. There’s usually a lot of good activities happening. There are resources that you can use at home by downloading or just coming in here,” Sherod said.

The Vermont Square Branch was designated by the Los Angeles Cultural Heritage Commission in 1983 after the community rallied to keep the building from being replaced. The exterior of the building remains the same, although the library was retrofitted for earthquake safety in 1990, a process that caused the branch to close to the public for six years.

Longtime Vermont Square resident Fletcher Fair told The LA Local she’s been going to the branch since the late 1960s, and the library will always be a cornerstone of the community.

“It’s the neighborhood library, and that’s where everyone went and prospered. We hung out, studied and partied,” she said. “There were a lot of events here.”

The first measles case of the year in Los Angeles County has been confirmed by the L.A. County Department of Public Health.

County public health officials said Friday a county resident who recently traveled abroad has been confirmed to have measles. Authorities have not identified any locations, other than healthcare settings, where the person could have exposed others.

Affected healthcare facilities are contacting patients and employees about potential exposure. County officials also are in the process of identifying those who may have had contact with the person.

Measles spreads easily through the air and can stay on surfaces for many hours. Those infected can spread the virus before showing symptoms, which can take weeks to appear.

Symptoms include a fever above 101 degrees; cough; runny nose; red, watery eye; and a rash that typically starts on the face.

So far, 588 measles cases of measles have been reported in the U.S. this year, the highest number of cases in a January since the U.S. eliminated measles in 2000. Most of these cases are linked to outbreaks in South Carolina, Arizona and Utah.

The L.A. County Department of Public Health is encouraging Angelenos to check their immunization statuses for a measles, mumps, rubella vaccine to determine if they’re protected against the virus.

Residents also should notify their health providers for guidance in the case of a potential exposure.

If symptoms develop, contact a healthcare provider via phone as soon as possible. L.A. Public Health advises people not to go physically into a health care facility before notifying them of measles symptoms.

The leaders of the Los Angeles Unified teachers union now have the power to call for a strike if they can’t reach a deal over pay, benefits and student support with the district.

United Teachers Los Angeles’ has about 37,000 members. Of those who voted, 94% voted in favor of authorizing a strike. The tabulation process lasted late Friday night, and results were announced overnight Saturday.

Union members, which include school psychologists, counselors and nurses, simultaneously voted to approve an agreement that preserves existing health benefits without increasing costs to educators.

The strike authorization vote does not guarantee teachers will stage a walkout this semester. First, the union must exhaust all steps of the collective bargaining process.

Stephanie Castro teaches seventh-grade English at Luther Burbank Middle School in Highland Park and voted for the strike authorization.

“ I will do what needs to be done to fight for these proposals,” Castro said. “I want to make it super clear to Angelenos that teachers don't want to go on strike. We absolutely would rather be in our classrooms with our students. … We also know that things cannot continue as they are.”

In a statement Saturday, the district pointed to other recent agreements with its labor unions, while also citing fiscal challenges related to declining enrollment and other factors: "We recognize the real financial strain on educators and staff but must make difficult decisions to preserve classrooms, student services and long-term stability within finite resources."

How did we get here? And what happens next?

UTLA’s bargaining team has met with the district more than a dozen times since negotiations began last February.

The union declared an impasse in December, a legal step that triggers intervention from a neutral mediator appointed by the state’s labor relations board.

On Wednesday, the mediator determined the two parties would move to the next step in the process, fact-finding, wherein a representative from the union, the district and the California Public Employment Relations Board collectively develop a recommendation to settle the negotiations.

The rejection of this panel’s recommendation could lead to a strike — or more negotiating.

As in previous contract talks, the proposals that cost the most money are those that take the longest to hash out.

The union is asking for raises and changes to the salary schedule so that newer teachers who complete professional development can earn increases more quickly. UTLA estimated before mediation that this would amount to an average pay increase of 16% the first year and 3% the following year. The annual ongoing cost to the district would be about $840 million.

The district has said it cannot afford what the union has proposed and has offered annual increases of 2.5% the first year and 2% the second year with a one-time payment of 1%.

“Significant distance remains between what the district can responsibly offer and what UTLA proposes,” read a Jan. 28 statement from LAUSD.

The union’s other proposals include more investment in arts education, legal aid for immigrant families and staff to support students’ mental health.

Castro, the middle school teacher, said she notices a difference when her students have access to the school’s psychiatric social worker and other wraparound services.

“It allows them to be fully present in the classroom,” Castro said. “They're not so worried about things that are happening outside of it and can really focus on that essay that they need to write or developing a thesis statement.”

Are you a UTLA member? Share your thoughts on your strike authorization vote with me via email.